Purpose: This study aims to analyze home confinement impact on individuals with neurocognitive disorders (NCD) through informal caregiver’s perspective and examine how it has affected caregiving burden. Methods: Thirty-six caregivers (64.94 ± 13.54 years, 41.7% female) of individuals with NCD (74.28 ± 6.76 years, 66.7% female) selected from the Body & Brain exercise program were interviewed over the phone. The following instruments were used: Barthel Index (BI) to assess care recipients’ ability to function independently on activities of daily living (ADL), the Neuropsychiatric Inventory (NPI) to evaluate neuropsychiatric symptoms, and the CarerQol-7D/ CarerQol-VAS to determine caregiver subjective burden/well-being. Results: Pre and post-confinement comparisons showed that care recipients significantly declined their independence in ADL (p = 0.003) and increased NPI total score (MD = 5.72; 95% CI: 1.19 to 10.25, p = 0.015). As for caregivers, results also showed an increased caregiving burden (MD = −0.17; 95% CI: −0.27 to −0.08; p = 0.001) and a decline in their well-being (p = 0.015). Discussion: COVID-19 crisis sheds light on how imperative it is to find solutions and design contingency plans for future crisis, in order to ensure properly sustained support to dementia caregiving dyads and mitigate caregivers’ burden.

For individuals with end‐stage renal disease (ESRD), the novel coronavirus can present several additional challenges in disease self‐management. This study aimed to explore the impacts of the COVID‐19 pandemic in non‐COVID‐19 patients with ESRD undergoing in‐center hemodialysis (HD). A mixed‐methods study was conducted with a purposive sample recruited from one dialysis unit in Portugal. Quantitative data were collected retrospectively from patients' medical records from February 2020 (T1—before the outbreak) and from April 2020 (T2—during lockdown). Semi‐structured interviews were conducted with 20 patients (66.9 ± 11.9 years old) undergoing HD for an average of 46.1 months (±39.5) in April 2020. Overall results suggested that dialysis adequacy and serum albumin levels decreased significantly at T2, while phosphorus levels increased. The findings from thematic analysis suggested several psychosocial negative impacts and impacts on disease and treatment‐related health behaviors (eg, difficulties managing dietary restrictions during the lockdown and diminished physical activity), which can partially explain these quantitative results. However, some patients were also able to find positive impacts in this experience and problem‐focused and emotional strategies were identified to cope with the demands of COVID‐19. Several recommendations have been made to mitigate patients’ emotional, relational, and educational unmet needs during the current pandemic and in the event of new outbreaks.

Successful dialysis in end‐stage renal disease (ESRD) largely depends on the patients’ ability to adhere to several clinical requirements and life‐style changes. Social support has been consistently linked to better health outcomes in a number of chronic diseases. The current study presents a systematic review of the literature on the relationship between social support and treatment adherence in ESRD. The search was performed on Web of Science, PsycInfo, ScienceDirect, and Scopus from January 19 to May 15, 2019. Two hundred and twenty‐four records were identified. After quality assessment, 17 studies were included for qualitative synthesis. This review comprised a total of 2362 patients. Most patients were on hemodialysis (97.5%) for an average of 58.2 months. Results suggested an overall pattern of mixed findings regarding the association between social support and treatment adherence. Adherence to fluid restrictions was the type of adherence with more significant associations with social support (63%). Mixed results were found for adherence to dialysis sessions (50%) and to medication (50%). Associations between adherence to diet restrictions and social support were found in 44% of the included studies. No significant associations were found between social support and adherence to follow‐up consults. All of the included studies combining several types of adherence into an overall score found significant associations with social support. Findings suggested that it might be particularly beneficial to focus future research and clinical efforts toward social support from family, significant others, and health professionals, to improve patient's with ESRD treatment adherence.

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Introduction:Caring for a patient with end-stage renal disease undergoing in-centre haemodialysis can be a stressful experience, likely to involve significant burden. Within the context of the new coronavirus pandemic, these patients are highly vulnerable to infection by COVID-19, which might increase the care demands and burden of family caregivers. Aim: This study aimed to explore the subjective experiences of family caregivers of non-COVID-19 patients with end-stage renal disease undergoing in-centre haemodialysis during the COVID-19 lockdown. Study design: A qualitative study was performed with a purposive sample. Methods: Semi-structured telephone interviews were conducted with 19 family caregivers (50.7 ± 14 years old) of patients undergoing in-centre haemodialysis in April 2020. Findings: Four major themes were identified: (1) emotional distress; (2) changes in caregiving responsibilities; (3) educational and supportive needs; and (4) coping strategies to deal with the outbreak and with the lockdown. Discussion: The findings suggest that family caregivers of patients undergoing in-centre haemodialysis have to manage several additional care responsibilities due to COVID-19 How to cite this article: Sousa H, Frontini R, Ribeiro O, et al. Caring for patients with end-stage renal disease during COVID-19 lockdown: What (additional) challenges to family caregivers?.

Humankind has been dealing with a devastating colossal pandemic, described as the greatest challenge of the 21st century in health and social care-dementia. Worldwide it is estimated that every 3 seconds someone develops dementia. This syndrome prevalence is not slowing down and already more than 50 million people live with it, a number that is expected to increase to 152 million in 2050. 1 Supporting this data, Alzheimer Europe estimated that almost 10 million people live with dementia in Europe. Portugal is alarmingly one of the most affected countries and will exceed the European trend by doubling its current prevalence to 3.82% of the total population until 2050. 2 Presently, we are facing another pandemic threat due to COVID-19, a highly infectious disease that rapidly spread around the globe. The first 2 cases of COVID-19 in Portugal were confirmed on 2 March 2020. On 12 March, the Portuguese Council of Ministers approved a set of extraordinary measures like closing schools, nurseries, kindergarten, and daycare centers to restrict social contact and group activities. The state of alert was declared on 13 March 2020. Following the exponential increase of cases, the Portuguese government declared the state of emergency and mandatory lockdown from 18 March till 2 May. Therefore, very strict measures of physical-social distancing were adopted to control the outbreak, which in itself represents a physiological and cognitive challenge with significant repercussions on health and wellbeing. 3 People with dementia (PwD) and their relatives' lives were highly impacted by these measures because many group activities and care-related services were canceled and visitors were prohibited in nursing homes for 3 months. Most day-care centers were closed on March 16th for an undetermined period without specific guidelines or recommendations, imposing this population to stay at home without premeditated support care. 4 Despite no official data is available on the prevalence of dementia across the various settings in Portugal, it is estimated

Abstract. The user experience of ubiquitous environments is a determining factor in their success. The characteristics of such systems must be explored as early as possible to anticipate potential user problems, and to reduce the cost of redesign. However, the development of early prototypes to be evaluated in the target environment can be disruptive to the ongoing system and therefore unacceptable. This paper reports on an ongoing effort to explore how model-based rapid prototyping of ubiquitous environments might be used to avoid actual deployment while still enabling users to interact with a representation of the system. The paper describes APEX, a framework that brings together an existing 3D Application Server with CPN Tools. APEX-based prototypes enable users to navigate a virtual world simulation of the envisaged ubiquitous environment. The APEX architecture and the proposed CPN-based modelling approach are described. An example illustrates their use.

Título: Bienestar hedónico y eudaimónico en la vejez a través de estudios psicológicos positivos: una revisión de alcance. Resumen: El estudio del envejecimiento a través de la lente de la Psicología Positiva permite mirar más allá de la disminución normalmente asociada con el avance de la edad y considerar experiencias y estrategias gratificantes para promover un envejecimiento con propósito. Con el objetivo de reunir evidencia sobre los principales avances conceptuales y empíricos que ilustran el compromiso de la Psicología Positiva con los temas del envejecimiento, se llevó a cabo una revisión de alcance. Los artículos que tenían "Psicología Positiva" y "Envejecimiento" (o palabras similares al envejecimiento) en su título, resumen o palabras clave fueron examinados en bases de datos principales y se buscaron términos relacionados con el envejecimiento en revistas bien conocidas de psicología positiva. Esta estrategia arrojó 48 artículos, 33 trabajos científicos originales y 15 revisiones. Se presentan los principales temas, diseños de estudio e instrumentos y se discuten los puntos finales de acuerdo con la perspectiva hedónica o eudaimóni-ca de los estudios. Se destacan las direcciones futuras relacionadas con la importancia de constructos comprensivos y estrategias metodológicas en el estudio del avance de la edad. Palabras clave: Psicología positiva; envejecimiento; hedonismo; Eudaimonia; bienestar; Revisión del alcance. Abstract:The study of aging through the lens of Positive Psychology allows looking beyond the decline normally associated with advancing of age and to consider rewarding experiences and strategies to promote a meaningful aging. In order to gather evidence on the key conceptual and empirical advancements that illustrate the commitment of Positive Psychology with aging issues a scoping review was conducted. Papers having "Positive Psychology" AND "Aging" (or similar words to aging) on their title, abstract or key-words were screened across main databases and aging related terms were searched in well-known journals of positive psychology. This strategy yielded 48 articles, 33 original scientific papers and 15 reviews. Main themes, study designs and instruments are presented and the endpoints are discussed according to the hedonic or eudaimonic perspective of the studies. Future directions related with the importance of comprehensive constructs and method approaches in the study of advancing age are highlighted.